Results from the seminal vesicle sparing prostatectomy trial.

55 Background: Prostate cancer accounts for greater than 200,000 cases each year. Although cancer control is generally favorable with treatment, side effects are common. Among men treated with surgery, nerve-sparing prostatectomy is associated with lower rates of incontinence and erectile dysfunction. Seminal vesicle sparing (SVS) may further limit damage to the neurovascular tissue surrounding the prostate. Although some surgeons practice SVS, evidence supporting its use is lacking. We implemented a randomized control trial to determine if SVS is associated with better functional outcomes compared to non-SVS prostatectomy. Methods: 140 men with early-stage (T1c/T2N0M0, Gleason score <= 7) prostate cancer and adequate erectile function (IIEF >= 21) were enrolled in the Seminal Vesicle Sparing Prostatectomy Trial (NCT01825642) and randomized to either SVS or non-SVS prostatectomy between 2006 and 2011. The Expanded Prostate Cancer Index Composite (EPIC) was used to assess quality of life outcomes following surgery. Results: 71 and 69 men were enrolled in the SVS and non-SVS arms, respectively. The predominant surgical approach was robotic assisted prostatectomy (>97% in both arms). Men in the SVS arm were slightly younger (56 vs 58 years, p = 0.02); however, there were no significant differences in other clinical or demographic factors. There were no cases of seminal vesicle invasion. PSA recurrence was noted in 3 patients (1 in SVS group and 2 in non-SVS group). At 12 months postoperatively, sexual (76 vs 75) and urinary incontinence (92 vs 94) scores were similar among SVS and non-SVS patients (both p > 0.2). Conclusions: Recovery of urinary and sexual function was common among men undergoing SVS or non-SVS prostatectomy. SVS did not negatively impact cancer control, but was not associated with enhanced recovery of sexual or urinary function, perhaps due to the high level of recovery of the control arm. Clinical trial information: NCT01825642. [Table: see text]

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Nerve Sparing Radical Prostatectomy for Early Stage Prostate Cancer

The Journal of Urology ◽

10.1016/s0022-5347(17)41254-7 ◽

1989 ◽

Vol 141 (5) ◽

pp. 1270-1270

Author(s):

P.C. Walsh

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Early Stage ◽

Nerve Sparing

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Frequent Methylation of RASSF1 and RARB in Urine Sediments From Patients with Early Stage Prostate Cancer

Medicina ◽

10.3390/medicina47030020 ◽

2011 ◽

Vol 47 (3) ◽

pp. 20

Author(s):

Kristina Daniūnaitė ◽

Artūras Berezniakovas ◽

Feliksas Jankevičius ◽

Arvydas Laurinavičius ◽

Juozas Lazutka ◽

...

Keyword(s):

Prostate Cancer ◽

Dna Methylation ◽

Early Stage ◽

High Sensitivity ◽

Bodily Fluids ◽

Prostate Carcinogenesis ◽

Frequent Event ◽

Aberrant Dna Methylation ◽

Noninvasive Biomarkers ◽

High Level

Background. Prostate cancer (PCa) is the second most prevalent malignancy among males, characterized by high mortality rates. Aberrant DNA methylation in promoters of tumor suppressor genes is an early and frequent event during prostate carcinogenesis. Modern techniques allow a sensitive detection of DNA methylation biomarkers in bodily fluids from cancer patients offering a noninvasive tool for PCa monitoring. Our study aimed at the analysis of DNA methylation in urine sediments from PCa patients for the selection of most informative noninvasive biomarkers. Material and Methods. Real-time methylation-specific polymerase chain reaction was used for the detection of methylated RASSF1, RARB, and GSTP1 genes in catheterized urine specimens from 34 patients with biopsy-proven early or medium stage PCa. Results. At least one gene was methylated in urine sediments from 28 cases with PCa, with a sensitivity of the test reaching 82%. RASSF1 was methylated in 71% (24 of 34), RARB in 44% (15 of 34), and GSTP1 in 3% (1 of 34) of the specimens. High level of methylation (≥50%) in RARB and RASSF1 genes was detected in 40% and 20% of cases, respectively. A significant association was observed between high level of RARB methylation and Gleason score (P=0.01), while methylation of at least one gene occurred more frequently in urine DNA of older patients (P=0.02). Conclusions. Results of our study show a high sensitivity of DNA methylation biomarkers, especially RASSF1 and RARB, for the early and noninvasive detection of PCa.

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Focal Cryoablation of Prostate: A Review

The Scientific World JOURNAL ◽

10.1100/tsw.2008.56 ◽

2008 ◽

Vol 8 ◽

pp. 486-491 ◽

Cited By ~ 4

Author(s):

Duke K. Bahn ◽

Paul D. Silverman

Keyword(s):

Quality Of Life ◽

Prostate Cancer ◽

Active Surveillance ◽

Early Stage ◽

Treatment Options ◽

Cancer Control ◽

Current Treatment ◽

Urinary Continence ◽

Radical Therapy

Current treatment options for men with early localized prostate cancer are either some form of radical therapy or active surveillance. Radical therapy is usually associated with significant adverse effects that might jeopardize a man's quality of life. Some observers believe that PSA screening has resulted in the over diagnosis and over treatment of prostate cancer. Many men are being diagnosed with an early stage, small volume, unifocal or unilateral prostate cancer but are reluctant to accept watchful waiting or active surveillance. Focal cryoablation is the less than complete ablation of the gland with ice. Based on review of the limited amount of material available in the current literature, focal cryoablation can provide acceptable cancer control while preserving sexual potency and urinary continence. Focal cryoablation may fill a void in the therapeutic options available to patients with unifocal or unilateral prostate cancer who have a strong desire to maintain their quality of life.

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A Comparison of Radical Perineal, Radical Retropubic, and Robot-Assisted Laparoscopic Prostatectomies in a Single Surgeon Series

Prostate Cancer ◽

10.1155/2011/878323 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Moben Mirza ◽

Kevin Art ◽

Logan Wineland ◽

Ossama Tawfik ◽

J. Brantley Thrasher

Keyword(s):

Quality Of Life ◽

Prostate Cancer ◽

Tumor Volume ◽

Surgical Margin ◽

Nerve Sparing ◽

Positive Surgical Margin ◽

Life Outcomes ◽

Robot Assisted ◽

Estimated Blood Loss

Objective. We sought to compare positive surgical margin rates (PSM), estimated blood loss (EBL), and quality of life outcomes (QOL) among perineal (RPP), retropubic (RRP), and robot-assisted laparoscopic (RALP) prostatectomies.Methods. Records from 463 consecutive men undergoing RPP (92), RRP (180), or RALP (191) for clinically localized prostate cancer were retrospectively reviewed. Age, percent tumor volume, Gleason score, stage, EBL, PSM, and QOL using the expanded prostate cancer index composite (EPIC) were compared.Results. PSM were similar when adjusted for stage, grade, and volume. EBL was significantly less in the RALP (189 ml) group compared to both RPP (475 ml) and RRP (999 ml) groups. When corrected for nerve sparing, there were no differences in erectile function and sexual function amongst the three groups. Urinary summary and pad usage scores showed no significant differences.Conclusion. RPP, RRP, and RALP offer similar surgical and QOL outcomes. RALP and RPP demonstrate less EBL compared to RRP.

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QUALITY OF LIFE OUTCOMES AFTER BRACHYTHERAPY FOR EARLY STAGE PROSTATE CANCER

The Journal of Urology ◽

10.1097/00005392-200003000-00033 ◽

2000 ◽

pp. 851 ◽

Cited By ~ 8

Author(s):

JUDSON M. BRANDEIS ◽

MARK S. LITWIN ◽

C. MICHELE BURNISON ◽

ROBERT E. REITER

Keyword(s):

Quality Of Life ◽

Prostate Cancer ◽

Early Stage ◽

Life Outcomes ◽

Quality Of Life Outcomes

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Prevention and managment possibilities of erectile dysfunction after radical prostatectomy

Orvosi Hetilap ◽

10.1556/oh.2009.28569 ◽

2009 ◽

Vol 150 (18) ◽

pp. 831-837

Author(s):

Péter Riesz ◽

András Rusz ◽

Miklós Szűcs ◽

Attila Majoros ◽

Péter Nyírády ◽

...

Keyword(s):

Prostate Cancer ◽

Erectile Dysfunction ◽

Radical Prostatectomy ◽

Early Stage ◽

Sexual Life ◽

Nerve Sparing ◽

Non Invasive ◽

Younger Age ◽

Detect Prostate Cancer

Radical prostatectomy is the curative surgical management of organ confined prostate cancer. Erectile dysfunction may follow surgery as the most common complication decreasing the quality of life of the patient. Thanks to spreading PSA screening probabilty increases to detect prostate cancer in its early stage and so the expected number of surgery is increasing, too. Higher number of operation as well as surgery more frequently performed in younger age calls the attention to the importance of erectile dysfunction and its management. Nowadays the physiology of erectile dysfunction due to radical prostatectomy has been revealed, and as a consequence, the nerve sparing surgery for its prevention is already known. The paper presents the different kind of possible invasive and non-invasive treatments of erectile dysfunction, and surveys their history and effectiveness. The erectile function of patients who underwent radical prostatectomy between 1998 and 2007 at the Department of Urology and Urooncological Centre was assessed by IIEF- and MMM questionnaire and letters with questions of habit of medicine taking. The results showe that 59% of patients who require sexual life are capable of it spontaneously or with medical management.

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Altered staining patterns and expression level of Engrailed-2 in Benign prostatic hyperplasia and Prostate Cancer predict Prostatic disease progression

10.21203/rs.2.14625/v1 ◽

2019 ◽

Author(s):

Qi Li ◽

Yibo Shi ◽

Rigai Sa ◽

Jun Hao ◽

Jinhao Hu ◽

...

Keyword(s):

Prostate Cancer ◽

Monoclonal Antibody ◽

Benign Prostatic Hyperplasia ◽

Cell Lines ◽

Early Stage ◽

Clinical Stage ◽

Prostatic Hyperplasia ◽

Expression Level ◽

Rt Pcr ◽

High Level

Abstract Background: Prostate cancer (PC) as a kind of malignant tumor, causes the most death of cancer among males. Successful curing of PC greatly relies on its diagnose in the early stage. Engrailed-2 (EN2), which has been confirmed being existed in the high level in the urine of PC patients, has not been reported as a histochemical diagnostic biomarker of PC. In this study, we analyzed the EN2 expression level and staining patterns in PC and benign prostatic hyperplasia (BPH) samples for seeing the change of EN2 in PC early stage. Methods: EN2 monoclonal antibody was generated and the specificity of this antibody was validated with different maneuvers. Endogenic and exogenous of EN2 in three PC cell lines (LNCap, PC3, and DU145) was detected by immunofluorescence. The expression level and staining patterns of EN2 in 25 of PC and 25 of BPH tissues were detected by immunohistochemistry. RT-PCR was done for further conforming whether EN2 is overexpressed in PC and BPH tissues. Finally, a relationship of EN2 expression and PC occurrence was obtained by case analysis of PC. Results: The results of WB and immunofluorescence showed the monoclonal antibody of EN2 we made could specifically bind endogenic and ectogenic EN2 protein in three different PC cell lines. Results of immunofluorescence showed the endogenic EN2 was generally expressed in the cytoplasm and ectogenic EN2 has mostly existed in the nucleus. Immunohistochemical staining of EN2 in PC was extremely higher than in BPH confirmed by RT-PCR. The staining areas were mostly nucleus and cytoplasm in BPH tissues but cytomembrane in PC tissues. The expression level of EN2 was positively correlated with the PC clinical stage. Conclusion: The EN2 monoclonal antibody we made could distinguish BPH and PC by immunohistochemistry. The expression level and tissue distribution pattern of EN2 can help with the determination of PC’s progression.

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